dssfaaaaaaaaaaaaaaaaaaaaaa For My Tummy

I just wrote that the studies had not been done, that compared or used treatments for IBS that cannot be marketed as drugs. That appears to be incorrect: see this news item.

On formytummy.com, I’ve talked about probiotics and prebiotics, fiber in the diet, brand names of products that are helpful, or not, and most of all, diet as a treatment for IBS.

But what is “Treatment for IBS” in an overall sense? You have a diagnosis of IBS, fine. Well, actually, not so fine! To get that diagnosis, you had symptoms. You would like one of two things:

  • to have the symptoms go away and never come back — A CURE, or if that is impossible
  • to have the symptoms calm down and let you live your life — A TREATMENT

As far as I know, no CURE for Irritable Bowel Syndrome, in the form of a pill that taken once, or twenty times, or monthly, or every day for life, exists or is in the medical pipeline. There are probably 200 to 500 different treatments for IBS advertised on web sites. There are television ads for products that seem to present a cure-all treatment for some irritable bowel syndrome symptoms. At best, they do NOT provide treatments for IBS. At worst, they can make things worse.

What Is Good Treatment for Irritable Bowel Syndrome (IBS)?

I am using the word “treatment” not in the medical sense, but in a practical sense. This practical sense involves step-by-step life-style change, dietary change, self-education, avoiding trigger foods, adding SOLUBLE fiber, taking one or the other of two specific probiotics.

I don’t get paid for writing this, or giving advice, in any way. I do recommend products I have used that have been helpful; there may be other such products in the same classification that will work, that I don’t know about, but I do believe following this regimen will improve uncomplicated irritable bowel syndrome.

Before we start - Definitions:
Fiber — does not mean Metamucil ™, despite what your doctor says. That’s partly because Metamucil has added flavors or sugar substitutes, and partly because it is too harsh to use from a standing start, for people with IBS.
Fiber — does mean either FiberSure ™ or Heather’s Organic Acacia Tummy Fiber ™, which use either soluble inulin or soluble material from the gum acacia tree.

Proportions

  • You can expect to feel 70% better as you get your diet under control.
  • Add to that another 15% better for improving your use of soluble fiber.
  • Add to that another 10% better for adding one of the recommended probiotics. Yes, your doctor is right to hand you a sample of Align ™ and suggest you take it. No, she doesn’t know that Digestive Advantage IBS ™ is equally good, and costs about one-third as much. Nobody has done the research.
  • You could add about 5% for following various tricks of the trade, such as “Never eat on an empty stomach” to bring it up to 100% improvement.

To find out more about these recommended changes to improve IBS, on this web site, start with the header, and read the IBS Triggers link, and then the IBS DIET material. These two sections will get you started on the diet.

And to make the diet work, follow these 7 principles:

I will soon add a post that indexes blog posts on the other elements of IBS treatment that I mention above.

A brief survey of the shelves at the local CVS store — Pharmacy and over-the-counter and variety stuff, for those who don’t shop there — reveals two newer items of interest to people with Irritable Bowel Syndrome.

First, there is now a CVS Probiotic — which is what they call it — in the Laxatives, etc. aisle. It contains the probiotic Bifidobacterium Infantis, which Align ™ calls Bifantis. The label says it is comparable to Align, and it costs $19.99. This product does not seem to be available online at www.cvs.com, however. Those of us who have wondered about the 28-day supply of tablets in Align ™ will be glad to know that in addition to being comparable to Align, the CVS Probiotic package includes 30 tablets, not 28. Ultimately I cannot vouch for this CVS product being completely comparable to Align.

Second, there is a CVS Fiber product that says to compare it to Benefiber. The actual ingredients, however, include dextrose, acacia, sucrose (sugar), guar gum, and other good soluble fibers — not the wheat dextrin of Benefiber, which contains a small amount of gluten.

My survey trip to CVS also revealed that Digestive Advantage-IBS, which had been available on the CVS shelves only in chewable form, with (a small amount) of sucralose — Splenda ™ — is now available in capsule form.

Seriously, yes. Recommended, effective, pill-form probiotics need to be taken every day — possibly for the rest of your life.

Several comments have asked this question. To keep IBS at bay in a gentle and effective manner, probiotics are a part of the solution.

I recognize that expense is an issue, especially if you have tried, and/or your doctor has recommended, Align ™.

Possible solutions:
* You can use our special Align code, to order Align at $25 /month, instead of $30 per month (the code is AlignWOM - as far as I know, it still works, and will work repeatedly.
* You can use Digestive Advantage - IBS, which was on the market earlier, and not promoted to Doctors in the same way. If you take the capsule or caplet form (not the chewables) it works, in my experience, as well as Align. For $17 or $18 you can get 96 capsules — a three month supply. A LOT cheaper than Align.

For my money, Digestive Advantage - IBS works as well or better than Align, although you may be more comfortable taking one in the morning and one at night, to build up the good bacteria. When I had to take a megadose antibiotic recently, I doubled DA-IBS to two in the morning, two at night, for a while. Then slowly went back down to 1 at night, two in the morning. Then back to one in the morning, one at night.

Basically, my reason for taking two per day is that

* It’s fairly cheap
* I’m covered if I forget one dose

Two per day costs $36 for three months, or $13 per month, less than half what Align costs. Align is a really good product — and I’ve taken some bad ones — but so is Digestive Advantage - IBS. Part of Align’s cost comes from marketing Align to doctors, sending out specialists in medical marketing to visit doctors,. writing and distributing literature to doctors, and giving them free samples.

I think it would have been nice if they had also put it on the pharmacy shelf next to Digestive Advantage - IBS. Now Align has the aura of a “medicine” for IBS, which it is not. There are probably other probiotics that will be fairly specifically engineered for IBS in the pipeline. How they will be marketed is the question.

One person comments “The symptoms are way worse than taking the pill.” Taking a daily probiotic is just part of the whole story for managing IBS. There are three parts to getting it all under control.

1. Diet
2. Probiotic (Align ™ or Digestive Advantage - IBS ™ are my current recommendations)
3. Soluble fiber supplement - Heather’s Acacia Tummy Fiber ™, FiberSure ™, or a guar gum supplement (cheaper, less appealing to use).

DISCLOSURE: I did receive two months of Align, before its widespread release, on the condition that I would take it every day, and blog about the experience - which I did. I rescued a comment from a manager at Digestive Advantage from my comment-spam file; in it he offered me the same deal — free product for two months, in exchange for blogging about the product on For My Tummy. There *is* the special $5 discount to blog readers, that applies to ordering Align online. There is no special discount to blog readers from Digestive Advantage - IBS ™, only that it is cheaper, and there is both a free sample and a $1.50 store coupon.

Thanks to Darlene, who wrote in a comment that she had found Align on the Costco website, for $24.99. The hitch is that they require you to purchase two packages at once. They also tack on a 5% surcharge for non-members. Then the shipping charge for standard shipping is 8.50. Here’s the total:

2 @ 24.99 = $49.98
Shipping & Handling: $8.50
Non-Member Surcharge:$2.50
Order Total: $60.98

Using the AlignGI.com web site to order, and supplying the ALIGNWOM Promo Code, cuts the price from $29.99 on the web site, to $24.99, with free shipping — but no shipping options.

The Costco option is listed on the AlignGI web site, as are some others. The Amazon option is not particularly great, unless you have an Amazon gift certificate — no free shipping, for example.

Also, their website gives explicit ordering instructions that you can take to your pharmacist. If the pharmacy is across the street, as mine is, that’s the simplest.

Background
For more information on the importance of soluble fiber in the dietary approach to IBS, see these earlier posts:

Fiber Glossary
, and
Fiber 101a, as well as
Fiber 101b.

Today’s web adventure:
Today, as I placed a regular supplement order with Vitacost.com, I somehow saw a long list of products. From idle curiosity, I scrolled down the page. I noticed that they listed guar gum, the main ingredient in the old form of Benefiber ™. Of course I clicked on the listing, and got two listings, for Source Naturals ™ versions of the same product.

Because I knew Amazon sells Source Naturals, and VitaCost had a shipment delay on one size of the Guar Gum product, I checked price and shipment information on Amazon.com, using “guar gum” for the search term. Yes, they have the same product, but you have to buy three at a time. Yes, it’s shipped directly from Amazon.com, so (especially if you are an Amazon Prime member) the ship time is very fast and accurate. Just to see what else there is, I checked their whole listing for guar gum. You can do the same — just avoid Bob’s Red Mill ™ or Barry Farm guar gum, which are intended for baking, and very hard to use as a supplement.

Believe me, I’ve tried.

At the bottom of the Amazon list of guar gum products, they had an allied ad from HerbalRemedies.com.
Poking around that web site, I found the following information on acacia fiber, the basis for Heather’s Organic Acacia Tummy Fiber ™.

Acacia General Information
Ancient Hebrews considered Acacia to be the Shittah tree of the Bible which supplied the sacred wood. The Ark of the Covenant and the sacred Tabernacle were made from Acacia wood. As a spiritual icon it is also one of the most powerful “symbols” in Freemasonry representing the eternal soul and purity of the soul. The ancient Egyptians used the gum of the tree on loose teeth because its thick mucilaginous (thick and sticky) properties supported the tooth while the astringent qualities tightened up the gum tissue surrounding the loose tooth. The Egyptians also used the material as a glue and as a pain reliever base. The gum of the Acacia tree was applied to open wounds as an antiseptic. The Aztecs used it as a food and dye, and ate the seedpods as an aphrodisiac.

Where The Acacia Tree is Found Today
The acacia tree (Acacia Senegal) is a thorny, scraggly tree that grows to heights of about 15 feeet. It grows most prolifically in regions of Africa, in particlular in the Republic of Sudan. During times of drought, the bark of the tree splits, exuding a sap that dries in small droplets or “tears”. In the past, these hardened sap tears served as the major source of acacia gum, but today commercial acacia gum is derived by tapping trees periodically and collecting the resin semi-mechanically. At least three grades of acacia gum are available commercially and their quality is distinguished by the coloor and character in the collected tears. There is considerable variation in the gum quality depending on whether it is obtained by natural flow secondary to extreme drought, obtained by tapping of induced by the boring of beetles at sites of branch injury. Gums derived from Combretum are readily available at low prices in East and West Africa and are often offered for sale as “gum arabic”.

Acacia Uses & Scientific Evidence For
Today Gum Arabic is used to provide a soothing coating over inflammations in the respiratory, alimentary, and urinary tracts. It is also helpful for coughs, sore throat, and catarrh, eyewash, diarrhea, and dysentery. Acacia is sometimes used for typhoid fever as well. Acacia is highly soluble, with low viscosity and a high soluble dietary fiber content, and therefore, used in meal replacement products, nutritional beverages, and weight-loss products. Acacia gum has been used in food as a stabilizer and in pharmaceuticals as a demulcent. It is used topically for healing wounds and has been shown to inhibit the growth of periodontal bacteria and the early deposition of plaque.

Post Summary
That’s comprehensive information on acacia fiber, when I started out looking for guar gum supplements — especially to replace Benefiber ™, which is now made with wheat dextrin. So in the next post, I’ll deal more specifically with guar gum as a soluble fiber, not just where to get the supplement.

Background
For more information on Digestive Advantage ™, see these earlier posts:
Four Weeks Review, and
Summary Review of my DA-IBS trial

Today
When I first learned of the Digestive Advantage TM offers for their IBS product, they seemed difficult to use and to claim. As a result, I didn’t make the offers widely known. Tonight I checked their web site in order to verify something I wrote in response to a commenter’s question about “natural probiotics.” The information about Free Samples and the Coupon is highlighted in contrasting colors at this URI: http://www.digestiveadvantage.com/prod_ibs.html#ingredients

For the free eight-day sample, you fill out your name, address, and email, with some additional information. I left off my age, and the form did not object in bright red letters, as so often happens. The “thank you” response says it will take two to four weeks for you to receive your free sample. The sample, an eight-day supply, is usually enough to decide whether DA-IBS is worthwhile.

I will report, once I receive it, on what form the sample takes–whether it’s the chewable tablets with Splenda tm or the generally “trigger”-free capsules.

On the other hand, the coupon, I would have said without checking, is available immediately, at least immediately after filling out another form, that only asks name, email, email confirmation, and “daytime phone number.” This last is marked in red, as an essential question. Since I work at home, it was okay to fill in my daytime phone number, but I can think of a lot of situations where giving your *real* daytime phone number is not worth the $1.50 coupon!

In my case, the coupon is available immediately but not yet, since I use the Firefox browser. There is a software download, which is fast enough, but then the software seemed to have a problem with my default printer–my only printer. The message told me that my default (only) printer wasn’t recognized or wouldn’t work with the software I had just downloaded. The instruction told me to right click on the “printers & fax machines” choice for default printer, and that didn’t seem to work either. Eventually, though, I got the message that I had to close the browser I was using, Mozilla Firefox. I took a chance, and just opened another browser, Internet Explorer 7, without closing out all the open tabs in Firefox. It worked.

This time the software downloaded perfectly and started up right away. After I signed the software agreement, it went right to work and printed out one coupon.

Bottom line: Use Internet Explorer 7, and think about what phone number you want to give.

Activity on ForMyTummy

I have not written articles recently, except for those that decry the claims made by Dannon Activia.

I do pay attention to anyone who writes a comment for this blog, and answer as soon as possible.

In about a month, I hope to start reviewing IBS books and new blogs. If you have found an interesting and helpful book, please let me know about it, or write a review for this blog. If we publish it, you would get publication credit in lieu of payment.

In the meantime, please feel free to look around and to comment on those posts you find interesting. There is a lot of basic information here.

See also the post on Dannon Activia.
You’ve got to be skeptical about the benefits of Activia when the ad I saw tonight said: “Eighty-seven percent of us report some problems with regularity and can [”therefore” is implied] benefit from Dannon Activia, with bifidis regularis.” That is my paraphrase of what I heard about an hour ago. My instant reaction was that either the 87% includes people with IBS or it doesn’t

  1. If people with IBS are included, then Dannon is making a medical statement that we can benefit from eating Activia, when it fact it may give us violent diarrhea (on top of “normal” diarrhea) because some of us are lactose intolerant. I don’t think that’s a benefit of eating Activia.
  2. If only people who don’t have IBS are included in the 87%, then that implies that the remaining 13% is composed of people who never have regularity issues and don’t need Activia, and people who *do* have “regularity issues”–because they have IBS–and *shouldn’t* eat Activia.

My guess is that if the statistic is *real* then what they did was ask, in a survey, “Do you ever have irregularity for any reason.” If that is the basis, then option #1 above applies. Dannon Activia is making a medical statement in promoting Activia as usable and beneficial for everyone in their 87% group, regardless of lactose intolerance. Or did they cook the statistic by weeding out people who had already told them they were lactose intolerant?

Someday we’ll know.

Again, the link to the previous post on Activia, and the comments.

Summary
Quick summary of the For My Tummy position:
Probiotics in pills or capsules that protect against stomach acid, GOOD.
Probiotics in food, exposed to digestive juices all the way to the gut, BAD.

Types of Probiotics
That is to say that probiotics such as Digestive Advantage-IBS ™ and Align ™, both reviewed on this blog, are helpful forms of probiotics, and the strains seem to help more than Acidophilus or the multiple strains in the Neutraceuticals products. Both Digestive Advantage-IBS ™ and Align ™ are encapsulated in such a way that they do not need to be refrigerated, as some probiotics do. They also seem to reach the gut and then have the intended effect of improving gut (large intestine) response in the digestion of foods on an IBS diet, and perhaps extend the range and types of foods that can be eaten.

Probiotics in Food
Probiotics as food additives are unlikely to produce such help, because they are unlikely to reach the gut with their probiotic bacteria intact. Dannon’s web site section for health professionals summarizes a study that says that indeed their probiotic travels the entire digestive tract and emerges in the same strength–and then omits all the details that help to judge a study’s validity. Not to mention that people with some digestive problems have lactose intolerance, strong enough that they cannot eat yogurt. The encapsulated pill/capsule form of probiotic stays together and protects the contents, the millions of “colony-forming” GOOD bacteria that will change the digestive activity in the gut in a good way.

Immune System Probiotics
This–the unlikeliness to be helpful–also goes for DanActive, ™ which contains “l-casei immunitas” ™ as its resident strain of bacteria. In contrast, if increased immune function is what you want, search here for the Ganeden Biotech product Sustenex ™. Sustenex provides an encapsulated form of patented probiotics that are designed to bypass digestive juices in the upper digestive tract. I’m holding off on a wholehearted endorsement, just because I haven’t investigated the research, and only know that Dr. Mehmet Oz is a fan.

Further Information
See the many posts here; search on “probiotics” and on “Dannon,” or select the category “Probiotics.”

Feel Welcome to Comment
Thanks for visiting; please leave a comment below, by clicking the “Comments” link.

Introduction
Every once in while I read a post on another blog that is so good that I don’t just sit back and think, “Now there’s a good post.” No, I sit back and think, “What an admirable, original post! I wish I had written something like that.” Sophie, who runs the IBS Tales blog, has just written that kind of post, on “Why self-diagnosis is so crazy.”

Listing Reasons
From time to time I see lists of IBS symptoms on web sites and blogs. Without giving it much thought, I say to myself “Perhaps For My Tummy should do something like that,” and then never write it. Of course I’m a procrastinator; that’s a perfectly good reason for not setting up a page with common symptoms of IBS. A second reason is wanting to think that readers come to this blog with some knowledge of what Irritable Bowel Syndrome is (or isn’t) and what the symptom picture is likely to be. A third rationale is not particularly wanting to specialize in either IBS-C (predominantly constipation) or IBS-D (predominantly diarrhea) or IBS-A (C and D are Alternating), nor discuss the specific forms that IBS takes–so I don’t discuss the typing of IBS according to current or historical symptom. It’s just IBS, and you know what kind you have, presumably.

Deepest Concern
AND the deep underlying ultimate reason is that I don’t want you, the reader, to diagnose yourself based on this web site. Use a lot of self-help measures, yes. Avoid things that don’t help, yes. Diagnose yourself, no. If that means you go get that colonoscopy your doctor says you need to have for a diagnosis, then this site will cheer you on and provide moral support–mostly metaphorical, it’s true. And for more encouragement on that path, of getting a real medical IBS diagnosis, read Sophie’s post.

Discuss
Do you have a strong reaction to this policy? See the “No Comment” link below–or if there’s been a comment, the link will have the number of comments? Click on that and a window will open that allows you to disguise your identity and tell us what you think.

About Lactose Intolerance
Digestive Health - Smart Brief has a note that points to excellent information about what is happening when you have lactose intolerance. I have had varying levels of lactose intolerance for much of my life; this article tells about the stages of lactose intolerance. This is a better description than the statistic “25% (if true) of people with IBS are lactose intolerant.” Yes, maybe in a cross-section of people with IBS right now that is not incorrect. I pessimistically suggest that if this statistic that’s been casually quoted elsewhere is survey-based, then it should be calculated for each age-group with IBS, not for the whole batch of us.

Because the author of the article cited in Digestive Health - Smart Brief, Pamela Stuppy, gets it right, I’m more inclined to believe her.

Your Comments, Please
Have you had changes in lactose tolerance during your life, where once “milk and cookies” were great, and now, not so much? Please use the “comment” link to send in your comments.